Trauma Medicine: First Aid for Burns

Jeremiah Johnson

Good Day to you, ReadyNutrition Readers, and welcome to another installment on our Wilderness and SHTF trauma series. As the title suggests, we are covering the information pertaining to burns. Not George Burns or Robert Burns: no comedy or poetry here. Just an attempt to make sure the joke’s not on you, and that when you treat these burns, your movements flow as if you’re “poetry in motion,” so to speak.

To prepare you for this type of injury, first we have to understand the mechanics and physiology of a burn. What is a burn? What happens when the human body suffers from a burn? How is it dangerous? These are all questions you may have wondered when you have heard of people suffering from burns in the past. A burn is tissue injury that is suffered as a result of excessive exposure to heat, chemicals, electricity, or nuclear (radioactive) material. Burns are classified in their severity by degrees, and they are as follows:

First Degree Burn: This is a not-so-serious but oftentimes painful superficial burn of the outer layer of skin. Redness, slight pain, and tender sensation to the touch are its indicators. Sunburn is your most common example of first-degree burn.

Second Degree Burn: This one damages both the epidermis (outer layer) and the dermis (inner layer) of the skin. Second-degree burns are painful and blisters are characteristics; they may heal and leave a scar/scar tissue.

Third Degree Burn: This is the most serious type. Third degree burns run all the way through the entire thickness of the skin, giving it a brown or blackened appearance. This burn, believe it or not, does not hurt in the initial site, because the nerve endings and nerve tissues have been completely destroyed. Scars usually form.

The reason that burns can be so severe is twofold: shock, and fluid loss. When the skin is damaged or destroyed, some of the things that occur is weeping and fluid loss. Picture the skin as being an elastic bag of tissues. When that bag is damaged, the underlying fluids are then able to leak out and move from one part of the body to another uninhibited. The skin surface is no longer able to keep in the intercellular and intracellular (between and within the cells, respectively) fluids, as they would normally be.

Remember Your A-B-C’s

Results of the burn can be the sloughing off (pulling off/slipping off) of the skin, gangrene, scars, kidney problems (from buildup of toxins), pneumonia, and respiratory problems. The first priorities on the scene when the patient can be treated are to ensure airway, breathing, and circulation (the ABC’s), after the first task is completed.

The first task: Eliminate the source of the burn or remove the patient from it.

Once this is done, conduct your ABC’s. Use blankets or clothing to dampen/put out any fires on the patient. In the event of an electrical burn, take precautions before touching the patient! Make sure the source of the electricity is turned off! If this cannot be done, use nonconductive material to remove the patient from the electricity or the electricity from them. An example: a downed power line is on the patient’s leg. Use rope, clothing, or dry wood to drag the patient away from the electrical source.

Chemical burns are more sensitive. Here are your precautions to follow:

Remove liquid chemicals from the patient by flushing with water

Dry chemicals must be brushed off of the patient. Do not add water! This may form a solution that is even worse than the dry chemical! Use a broom or a dust broom, or articles of clothing to brush the dry chemical away.

Now that you have dealt with the burn source, continually assess your patient. In a recent article on trauma medicine, I discussed the importance of following your A-B-C’s. That is, Airway, Breathing, and Circulation.

A-B-C’s are your priorities for your patient, in that order, the bare bones (no pun intended!) beginning of the primary survey.

Airway: Does the patient have a clear airway that allows for air exchange? Is he gurgling or gagging? You must visually inspect while protecting the C-spine (cervical spine) that should immediately be immobilized for the patient’s safety. If the airway is not cleared it must be cleared (if patient is unconscious, an oropharyngeal airway may need to be inserted).

Breathing: Is he breathing on his own? If not, he’s probably unconscious in which case you must perform CPR. The brain can only survive about 6 minutes without oxygen.

Circulation: Is he bleeding? Does he have a pulse? Is it strong and regular, weak and thready? What is the characterization of the pulse?

Make sure he has no obstructions to his airway, make sure he is breathing regularly, and that he has a pulse and heart beat and is not bleeding/losing blood. Now it is time to uncover the burn.

Cut the clothing away from the burned area and lift it gently, being careful not to remove any burned tissue with the clothing. You will apply a dressing at this point to keep the wounds clean and covered. The main important thing here is to protect those burns from further injury or infection. Next: get him or her to a doctor and definitive medical care. The dressings should be placed over the burns to prevent them from slipping; however, they should not be too tight to constrict either blood flow or further injure the patient. Always tie any tails of dressings in non-slip knots on the edges of the dressing and not over the wounds (burns) themselves.

Conventional and Natural Pain Relievers For Burns

Analgesics for burns include (but are not limited to): aspirin, acetaminophen, ibuprofen, and naproxen. These can provide pain relief. Others are lidocaine and benzalkonium chloride (Bactine), and benzocaine for topical relief.

Herbal aids include:

Aloe (Aloe vera)

Calendula (Calendula officinalis)

Comfrey (Symphytum officinale)

Gotu Kola (Centella asiatica)

Tea (Camellia sinensis)

Lavender (Lavandula angustifolia)

There are others as well, but these are some of the mainstays that you can add to your herbal first-aid kits in a readily available manner that it relatively inexpensive and prescription-free.

The risk of complications arises when 25% or more of the body is burned. Always seek definitive medical care, as these complications can warrant things such as tetanus shots and antibiotics. As in other articles, the information here is presented for informational purposes and is not meant to diagnose, prescribe, treat, or assess any condition or illness as outlined. Consult with your family physician prior to taking any action pertaining to the information provided herein. Be safe, and remember: an ounce of prevention is truly worth a pound of cure.

JJ

Jeremiah Johnson is the Nom de plume of a retired Green Beret of the United States Army Special Forces (Airborne). Mr. Johnson was a Special Forces Medic, EMT and ACLS-certified, with comprehensive training in wilderness survival, rescue, and patient-extraction. He is a Certified Master Herbalist and a graduate of the Global College of Natural Medicine of Santa Ana, CA. A graduate of the U.S. Army’s survival course of SERE school (Survival Evasion Resistance Escape), Mr. Johnson also successfully completed the Montana Master Food Preserver Course for home-canning, smoking, and dehydrating foods.

Mr. Johnson dries and tinctures a wide variety of medicinal herbs taken by wild crafting and cultivation, in addition to preserving and canning his own food. An expert in land navigation, survival, mountaineering, and parachuting as trained by the United States Army, Mr. Johnson is an ardent advocate for preparedness, self-sufficiency, and long-term disaster sustainability for families. He and his wife survived Hurricane Katrina and its aftermath. Cross-trained as a Special Forces Engineer, he is an expert in supply, logistics, transport, and long-term storage of perishable materials, having incorporated many of these techniques plus some unique innovations in his own homestead.

Mr. Johnson brings practical, tested experience firmly rooted in formal education to his writings and to our team. He and his wife live in a cabin in the mountains of Western Montana with their three cats.

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